Please visit www.jewishwomenshealth.org for a wide range of articles and case studies on the topic of women's health and Jewish Law. This website is designed to assist medical practitioners in providing optimal care to their observant Jewish patients.

Information to Provide
BEFORE a Gynecological Examination/Procedure

The information that is important in rendering a halachic ruling is summarized in the following list of questions. This form can be printed out as a written report whose completion will minimize the chance of errors in transmission. Click here, for the printable form.


Name of procedure / type of examination: ______________

1. Must the examination or procedure be scheduled at a specific point in the menstrual cycle?
[ ] yes [ ] no

2. If so, at what point in the cycle? __________________

3. If there will be a need to enter the uterine cavity, what is the diameter of the instrument that will enter the cervical canal? _____ mm.

4. Will a tenaculum be used?
[ ] yes [ ] no

5. Could the examination or procedure itself lead to any spotting or bleeding?
[ ] yes [ ] no

6. If so, what is/are the likely source(s) of the bleeding?

[ ] vaginal wall
[ ] outside of cervix
[ ] cervical canal
[ ] uterus

7. For how long is bleeding expected to last? (For example, the scraping of a Pap smear may be followed by a day or so of spotting.) ______ days 


Users of Internet filtering services: This site discusses sensitive subjects that some services filter without visual indication. A page that appears 100% complete might actually be missing critical Jewish-law or medical information. To ensure that you view the pages accurately, ask the filtering service to whitelist all pages under jewishwomenshealth.org.


This material is intended for general information purposes only. The patient's individual circumstances should be considered when making specific treatment decisions.

Reproduction of the contents of this article for other than personal use
is prohibited by both Jewish and secular law.


Copyright © 2012 Deena Zimmerman. All rights reserved.